NPI | 1518222868 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005362) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 13451) |
Enumeration Date | 2012-07-11 |
Last Update Date | 2022-07-21 |